Tuesday, December 1, 2009

Partners in Life, Partners in ADHD Awareness

You share a life together – maybe even a bed, a checking account, and human offspring, too. It might sound surprising (especially to some less-than-savvy physicians and therapists), but ADHD evaluation and treatment outcome also typically benefits from a shared "team" approach. Let's examine the reasons why.

Elaine finally decided to seek professional help for her long-ago diagnosed ADHD. But it still took her three months to actually book the appointment. Unfortunately, that therapist ended up knowing little about ADHD, and Elaine gave up on finding another one on her insurance plan. “She gives up easily with most obstacles," boyfriend Brian explains, "and then she also quickly forgets why her ADHD is a problem -- until she loses her next job." For a long time, Brian didn’t push her because he didn’t like the idea of "acting like Big Daddy." Intervening just didn’t seem healthy.

Then again, Elaine's problematic ADHD symptoms presented fertile ground for a bumper crop of unhealthy behaviors on both their parts. Nagging on his part. Denying and blaming on his part. Just to name a few.

Finally, Brian realized it wasn’t a question of Elaine learning to be a "more responsible adult" or him being a "dominating male" if he stepped in to help. “If she suffered from allergies or maybe a knock to the head that resulted in cognitive impairment similar to that of her ADHD symptoms, I wouldn’t expect her to go it alone, would I?”

Once he clarified this in his mind, he could think about collaborating in finding a more qualified professional. "With all the hoops we have to jump through – first of all, finding a competent clinician and then finding someone who accepts insurance – Elaine really needed my help in planning and persevering."
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Genevieve had worked patiently for months to encourage husband Larry to talk to a professional about his chronic “monologuing” in social situations, forgetting important details about important clients, and creating one costly fender-bender too many.

Moreover, Larry's brother was recently diagnosed with ADHD and their two children have it as well, so Genevieve thought Larry was good candidate for an evaluation. That's why she was flattened by the doctor’s assessment of her husband: “Well, you probably have ADHD, but if you made it this far in life, you don’t need to worry about it now.”

The physician had not conducted a full evaluation—more like a quick eyeballing with questions like, “How’re you doing?” And he did not ask for the perspective of a spouse or other loved one, which ADHD experts recommend (more about that soon). As a result, this doctor had no clue about Larry's actual impairments—the ones he doesn’t remember, never notices, or didn’t think relevant to tell the physician—or the exhausting amount of compensation Genevieve provided for her husband.

Unfortunately for this couple, Larry decided that physician's word was gold and he admonished Genevieve never to utter "ADHD" again in his presence.

These stories are true, gleaned from hundreds gathered over my years of moderating Adult ADHD discussion groups (separate groups for the adults and for the partners of adults with ADHD), and they describe two common obstacles to achieving an accurate diagnosis and positive ADHD treatment outcomes:

ADHD symptoms can obscure a person's ability to clearly perceive the full negative impact of his or her challenges (often called "denial"). Moreover, ADHD symptoms can inhibit the ability to initiate and follow through on pursuing an evaluation and treatment—typically no trivial task, given the managed-care hoops we all must jump through. As Ted explains, “My wife read an article about ADHD in relationships and said, ‘Wow, this is us’ but then she’d forgotten all about it by the next day!”

2. The physician failing to solicit the perspective of an interested third-party—typically a partner but also a family member or close friend.

Even if invited by the clinician, some partners of adults with ADHD initially balk at becoming involved, but their reasoning isn’t always logical.

For example, they bitterly complain that they are tired of their ADHD partners acting like children, leaving them to pick up the mess, do all the reminding, all the prodding. Yet, when it comes to helping their partners pursue an ADHD evaluation and then treatment—in other words, gaining the tools to finally start acting more like more mature adults—they might say, “Oh, that’s too much like parenting.” Unfortunately, their therapists often encourage this attitude, by calling such assistance enabling or codependent.
Jazmin had a similar resistance when she entered the psychologist’s office exhausted by propping up her husband of six years, only recently diagnosed with ADHD. She bristled when the psychologist suggested that she needed to help just a little more. Then the psychologist explained that her husband’s unaddressed ADHD symptoms (procrastination, distractibility, and so forth) meant he was unlikely to successfully follow through on the psychologist’s recommendations. Jazmin agreed to try.
She found a psychiatrist qualified to treat ADHD, made the appointment, and went with her husband to the doctor. With that help, her husband was finally able to start on the path to success. The psychologist in Jazmin’s case was ADHD expert Michele Novotni, coauthor of What Does Everybody Else Know That I Don't?: Social Skills Help for Adults with Attention Deficit/Hyperactivity Disorder.
Novotni fully admits that asking Jazmin to intervene sounds like unorthodox advice. After all, aren’t adults supposed to be responsible for themselves? “I know it isn’t supposed to be this way with couples,” Novotni concedes, “but this is often necessary in order for the individual with ADHD to get the help that’s needed.”
This type of support, she emphasizes, should not be confused with codependent caretaking. To be clear, accepting that your partner’s ADHD-related deficits might impede treatment does not absolve him or her of responsibility. “It’s very important that the ADHD partner actively participate in the treatment process,” Novotni urges. “Over time, the ADHD partner will be able to assume more responsibility for his or her own treatment. That, however, should be a goal in treatment, not a demand for beginning it.”Of course, it must be emphasized: Not every adult with ADHD needs a third party's involvement. ADHD is a spectrum condition, after all, with many points on the spectrum. Some people are more aware of their challenges than others and better able to take notes in sessions with care providers and follow up on suggestions.
In recent years, it’s also become easier to find therapists and physicians who are highly qualified to evaluate and treat ADHD, yet it still takes some detective work. Oftentimes, two heads remain better than one, especially when it comes to assessing the professional’s thoroughness and competence during office visits.
Below, leading ADHD experts and some partners of adults with ADHD explain why they consider a team approach critical to the evaluation and treatment process.

Leading ADHD Experts Weigh In:

"Most psychiatric patients will come in and say there are changes. The person with ADHD doesn’t complain of any changes at all. They have been like that all their lives. They aren’t often objective. When they hear others describe their behavior, they feel it is someone else being discussed. One handles that clinically by not being accusatory. Yet, it’s essential, when possible, to talk with the partner. I find it mandatory for an evaluation of a patient’s status. Besides defining the problem, which the patient might not recognize, the partner is also able to recognize changes as the treatment progresses. It’s essential to have that information."—Paul Wender, M.D., pioneer in the diagnosis and treatment of pediatric and adult ADHD, in a 2007 interview with Gina Pera

"What is one of the cardinal symptoms of ADHD? Failing to pay attention to both outer and internal phenomena. Psychologist and ADHD researcher Russell Barkley has followed up on the children with ADHD from a study he conducted in the late 1980s. These subjects are now in their early twenties. How many of them still have ADHD? It depends on whom you ask. If you ask those young adults, it’s 5 percent. If you ask their parents, it’s 50 percent. Moreover, if you loosen the diagnostic criteria to measure the adult manifestations of ADHD, as opposed to those of children, it is nearly 70 percent. The moral of the story: Even for the diagnosis, much less for the treatment plan, you need another person’s corroboration." —Stephen Hinshaw, Ph.D., ADHD research investigator, Professor and Chair of the Psychology Department at the University of California, Berkeley, in a 2007 interview with Gina Pera

"Part of the reason why adult psychiatrists have not previously identified ADHD in adults may be that, unlike their child counterparts, most adult assessments focus on the patient rather than other informants. This means that the psychiatrist only has access to information about family complaints or employer frustration to the extent that the patient is aware of those perspectives. With ADHD, insight is variable…. By comparing the reports from two different informants, the clinician has access to multiple informants and a sense of the compatibility of the patient’s report with that of others for the full range of comorbid diagnoses. For example, the clinician may observe that the patient does not identify difficulties such as lying, defiance, or poor social skills, but these are major areas of concern for his or her spouse. On the other hand, both patient and informant may show good agreement on report of ADHD symptoms. This feedback is in itself helpful to the patient." —Margaret D. Weiss, M.D., Ph.D., and Jacqueline R. Weiss, M.D., “A Guide to the Treatment of Adults With ADHD,” The Journal of Clinical Psychiatry 2004;65

Partners of Adults with ADHD Speak Out:

"Whoa! I looked at my husband’s partially completed ADHD evaluation form. It asks if he can concentrate when he reads. He wrote, “yes.” But he can’t even finish one short newspaper article! What if he answers all the questions inaccurately and I’m not there to set the record straight? From what I hear in the support group, some doctors and therapists are easily fooled. Yet I know if this doctor says, 'No, you don’t have ADHD,' my husband will say, 'Case closed!' Then what do I do? —Leslie

"My boyfriend doggedly tried to find help for years but he didn’t know he had ADHD, and the doctors never asked the right questions and never asked for input from family or friends. Consequently, they had him on antidepressants, anti-anxiety pills, and you name it—plus therapy—none of it working and some of it making things worse. I finally figured out he might have ADHD, but his HMO had no ADHD specialists, and my boyfriend didn’t have the mental stamina to battle with them. Plus he lacked the judgment to know if a physician was well qualified. If I hadn’t gotten involved, I’m sure my boyfriend would have given up or done something tragically desperate. He was at that point." —Dana

"After two years of so-called ADHD treatment, my wife casually mentioned how she feels like crap most of the time—”fuzzy,” disorganized, and unmotivated— until she visits her physician. Then the excitement of having the doc’s focused attention perks her up and she feels good. As a result, she’s been telling him that she’s doing great! That means her entire treatment has been based on how she felt while she was in the doctor’s office, with the facts of yesterday lost in the mist of time. No wonder treatment hasn’t helped!" —Hank

"Part of the reason my boyfriend didn’t get better for so long, despite his wanting to, is that he was too embarrassed to talk honestly to the doctor about whether the medication was helping and how his life was really going. He always just said, “Things are fine.” So now either his brother or I go with him. He says he’s relieved to have our help articulating his challenges and his progress because, on his own, he gets 'brain freeze' when he walks in the office door." —Tammy

"Your partner might not be able to accurately describe or recall the problems experienced or the impact of medication on behavior—or remember the physician’s or therapist’s instructions. If your partner is highly defensive, explain that you want to go so that you can learn how to be more patient and understanding. It might sound manipulative, but when you’re dealing with a person in denial of his or her challenges, that’s often what it takes to help them to a point of clarity."—Susanna

When it comes to seeking an evaluation or treatment for ADHD, what has been your experience?

If you're an adult, did you "go it alone" and did that work for you—or could you have used a partner's input?

If you're the partner of an adult with ADHD, what are your reasons for wanting to be involved—or having nothing to do with your partner's ADHD evaluation or treatment?

20 comments:

I sought treatment at my own insistence, have never regretted it for a second, and I am one of those who falls on the spectrum in an area where I don't need a "caretaker" despite my impairments (as you may have read recently in my blog, lol). I need a partner who can respect my unconventional organizational needs and trust me to be diligent in working to do the right thing...because I really am and I really do, and I deserve that trust, even if I might have an occasional (lately frequent, haha) meltdown. I will always have to revisit and reaffirm even solutions that are effective...but I AM committed to the sometimes exhausting process of learning to live my life more effectively, and I always pop back up after a bout of frustration to own my reality, whatever it may be.

Because my last partner was not able to be supportive of my very reasonable requests for this kind of autonomy and respect, I asked him to leave, and I don't regret it.

He would tell me I was doing great, and that he was proud of me...but then second guess how I organized myself, even when it was working for heaven's sake (he agrees that this was what was going on)...and MOVE my visual cues even when (by his own admission) they were not creating problems for him. He just needed to be in control at the expense of my autonomy, and the effectiveness of my treatment process. Classic toxic caretaking behavior.

It's one thing to have someone questioning you on things that aren't working...but on the things that are? Please...we ADHDers don't need any help increasing our feelings of self doubt. I ASKED for diagnosis, I ASKED for help, and I was willing to drink the treatment Kool-aid...I deserve respect not as a perfect person, but as a hard-working and proactive person.

So I tried to involve him...I can't say he was 100% supportive, but the ways in which he was unsupportive were so destructive to me that I had to let the relationship go to save myself. It takes a lot to walk into a mental health center and say "I need to talk to someone because I'm pretty sure there's something wrong with my brain". I wanted me healthy and for his own reasons, he needed me broken. Clearly our individual goals for my treatment were not in alignment ;)

I am a partner of an ADHD adult. He was diagnosed a few years ago, when our 18 year old son was diagnosed. (They are both highly gifted so it was always hard to know what the problems really were coming from) He started treatment but it didn't work so he quit. I have been trying to encourage him to try again, and he gets defensive and tells me I am the one who needs to go see someone. It is very hard to balance trying to help without being a "nag". I don't mind helping as long as someone wants my help and they are helping themselves. Also, our almost 21 year old son will not get help for his ADHD, and we disagree on how to help him. I think he is enabling him and he needs to use more tough love because although, we have tried to encourage treatment for our son, he refuses help. Natural and logical consequences works for me, but my husband wants to keep rescuing our son. Is there info out there as to what to do in my situation with two family members not getting help for their ADHD?

Oooh. "Natural and logical consequences"...I love the way you put that, because it's so painfully true that we DO need them. Though one of the things that frustrates me the most about being an adult ADHDer...is the fact that there is generally less correllation between those natural consequences and changes in my behavior than there might be for someone without my brain. I think you understand that the problem is just that there are more layers than that to be unravelled each time we run up against an obstacle that requires change...which means that accepting the need to change feels much more daunting. But that DOES NOT MEAN that you should not give your son natural and logical consequences. Just because he has a greater number of layers to unravel to face and change his outcomes doesn't mean he shouldn't be challenged to do it. I hate it myself that I can "see" the problem and frequently can see at least some of what might help the problem...but connecting action to thoughts is just plain hard work, over and over and over. I do not regret embracing that challenge though and hopefully some day your son and husband might move in that direction.

I'm sorry you've had difficulty getting your family members on board with seeing that treatment could be beneficial to them...I guess my feeling is that it's kind of selfish for us to expect others to absorb the consequences of our ADHD if we ourselves are not at least trying to meet and greet and stare them in the face. Part of the nature of the beast perhaps...and it really is weird to have to admit that you have a "problem" with your brain and with your perception of the world around you. We shouldn't use that reasoning to sanction abuse of our loved ones though :(

It most certaintly is very important to have someone who knows you well, to be with you at your appt., if you are being examined and taking tests for an evaluation.

When I was notified of my appt. w/a NueroPsychologist, I was told that I must, have my wife w/me, and that she would need to talk w/the Dr. while I was being tested.(was an all day test).

At that time, neither one of us knew what was happening to me, only that I was having trouble with my memory,attn.,etc.

I now know why. The Dr. needed to know what my wife knew about my past behavior of my whole life. I would'nt have been able to see what I can see now, and tell him.

I am now starting to see(w/the help of medication and study) the way I was. I am not a different person now, but I can avoid some problems when I am able to see what could happen if I don't stop and think about what I'm doing.

You wrote: "Please...we ADHDers don't need any help increasing our feelings of self doubt. I ASKED for diagnosis, I ASKED for help, and I was willing to drink the treatment Kool-aid...I deserve respect not as a perfect person, but as a hard-working and proactive person."

Of course I absolutely agree! The strategy outlined above assumes that the "partner of" is acting in good faith and not out of some hyper-controlling need to have the partner with ADHD do things "their way."

Congrats to you for knowing your boundaries and not allowing yourself to be pushed around. When a strategy works for you and truly doesn't "leak" into your partner's space (mentally or physically), that should be celebrated.

Of course, many relationships have issues with "power" and "being right" -- whether or not ADHD is involved. Good for you, learning these lessons in your youth. :-)

"Denial" of ADHD symptoms is such an incredibly huge problem -- among individuals, the mental health community, society in general, and so on.

As far as I know, my book is the only ADHD-focused book to explain both the psychological and physiological aspects of "denial" with ADHD. The information is so needed, I gave permission to CHADD's Attention Magazine to excerpt the chapters, free of charge.

CHADD members can read them online at the Attention Magazine archives, which I link to in the intro to this post:http://adultadhdrelationships.blogspot.com/2009/11/gifts-of-adhd-lew-mills-phd-mft-you-can.html

The more the family members learn about the neurobiology of ADHD, the more they can learn how to reach through, under, around, and over a person's denial.

Gina,Your article about denial was wonderful.I have circulated it to several people on my professional listserv, and copied it to give to several of my patients.Thank you for making it so accessible here.It's worth reading again and again!

Thanks folks. I must say, I think I was the first person to really "ring the bell" on denial and ADHD. And for that I am very proud, because it gave people new ways of communicating to their loved ones instead of saying, "You're so stubborn" or "you're just in denial." Not helpful!

And thank goodness I found Dr. Xavier Amador, who has worked so diligently and compassionately to research the notion of "denial." He was so kind to share his knowledge with me, so I could put it in the context of ADHD.

Just this week I was wondering why I let my husband make decisions even though I know his judgement is impaired. I was feeling like an idiot for allowing his behaviour to cost us our house and our quality of life. Because he hasn't been able to motivate himself to get a job for the last 3 months I may have to sell my beloved VW Beetle as he signed a 3 year lease on a car (!) that we can't afford to get out of.I've been married nearly 21 years to this lovely guy and for much of those years I thought I had married an alcoholic. My dad was an alcoholic and a very cruel, stingy man. My husband is a kind and generous person. They call Alcoholism the disease of denial so after reading these blogs I can see why I acted the way I did. As my husband as gotten older alcohol doesn't cheer him up the way it used to. He used it to focus as well, weirdly some of his most logical conversations were when he had been drinking. I only just found out that it is the ADHD that causes them not to remember the next day not the binge drinking. Actually we haven't even been for a diagnoses yet but I have been studying ADHD all year; books and blogs etc and I'm sure that is the problem.Thanks to all you guys that share here as it can be a lonely confusing place to be in a relationship with someone not always inhabiting the same reality as you.Thank you to to Gina

I'm so glad to hear that you are finding your way out of the fog. If we don't know what we are looking for (in this case, ADHD), we often attribute the behaviors to something else. In your husband's case, alcoholism, perhaps because that was the "filter" you knew.

I have not heard that ADHD is the reason for not remembering the next day what transpired while binge drinking. I think this happens even among people who don't have ADHD.

But definitely many people with ADHD "self-medicate" with alcohol (and marijuana and.....). As I understand it, alcohol is immediately a stimulant (which might account for the more lucid conversations your husband has after drinking alcohol) but shortly becomes a depressant. After a while, the alcohol has its own adverse affect on the brain, compounding ADHD symptoms, depression, etc.

In your husband's case, it's definitely important to look at his lifelong challenges since childhood. That will help you to work with a professional on arriving at the proper diagnosis.

I encourage you to work with your husband on pursuing an evaluation and treatment. It sounds like you cannot afford not to.

I am not aware of the denial article, being very new to CHADD. But, I would love to read it. My husband is AD/HD; it's never been in doubt for me. But he is in major denial (he's in a midlife crisis, but denies that, too). My therapist agrees that he has all the symptoms (of both), and all of our extended family agrees, too. He's the only one who won't face it; and then I was diagnosed last year...and it changed my life. I literally felt like I had a new lease on life after being misdiagnosed with depression, anxiety, and being called "high strung" all my life. I got on meds (I'm also slightly OCD), and feel better than I have in 20 years. I attended the recent convention in Atlanta, and have learned so much about this condition because our two children have it (plus my dtr in her late 20's), and I homeschool the kids. So, my situation is completely opposite of what you are describing above. I have been responsible and have sought help, take my meds, am in counseling, read everything I can get my hands on, am learning and teaching the kids coping strategies, etc. etc .But, he is in complete denial, and although he knows all the symptoms and actually got angry when our dtr was diagnosed last year (angry at the ignorance of his parents/teachers that caused him years of misery), he still gets upset at the kids when they demonstrate their symptoms daily! But, he refuses to get knowledgeable, see our AD/HD psychologist, even consider meds or therapy - and is certain that he has figured it out and has no symptoms to speak of. After 19 years of marriage, I beg to differ. His coping strategies are to let everyone ELSE cope with his chronic lateness, impulsiveness, financial messes, lack of concentration and focus in conversation, communication inadequacies, etc. etc. And guess who has had to pick up all the slack? Yours truly. How do I live with someone like this? I am angry at his selfishness, arrogance and indifference to something that has diminished our lives for years, but that could be so easily dealt with.

ADHD PARTNERI am married 3 years now with a ADHD 24 year old woman, we had trouble half of our marriage. Now we have 8 months going to psichiatrist and he medicated my wife with ritalin after he diagnosticed ADHD, I saw positives changes the first weeks, now is the same ADHD conditions as before but reloaded, her impulsiveness originates destructive fighting and yelling about 2-3 times a month, last one my wife yelled an hit me in front of our kid. I think it is over for our marriage, I cannot deal with physical abuse, doesn't matter it comes from a "special ADHD person" we are speaking about divorce and talking to lawyers at the moment. She also lied to me that she did not finish high school because of learning disabilities, I just found out 2 months ago when confronted her to show me her grades. There is no confidence because of her lyings and no more patience for her aggressiveness and impulsiveness, what I am going to miss the most is our 2 kids. ¿Should I stop the divorce and throw my life into this marriage with her?

I'm so sorry to hear your family is experiencing such stress. It's certainly not good for anyone, especially the little ones.

Of course neither I nor anyone else can advise you on the next step.

I will say, however, that shared-custody with a spouse whose untreated ADHD is creating significant problems is seldom easier than staying in the marriage. Moreover, it is much harder to evoke change once you've removed yourself from the marriage.

If you read this post, you know that ADHD treatment often requires a team effort. If you read my book's chapters on medication, you know that getting the medication right seldom happens on the first effort.

For some people, Ritalin can cause as many problems as it solves because it is a short-acting medication that can create a "Ritalin rollercoaster." I'm betting that your wife's anger and fighting escalated when the medication was wearing off.

Perhaps it was generic Ritalin, which can cause a different set of problems in some people.

My point is that your wife might not be getting anything close to optimal medical treatment.

Have you both been going to the psychiatrist for 8 months? Are you sure it's a psychiatrist (MD)? Are you receiving talk therapy and psycho-education about ADHD? I'm not sure what you mean when you say you have been "going to" a psychiatrist.

As for the misrepresentation of her high school graduation, it is not uncommon for people with ADHD to feel great shame about past failures, to the point of not wanting other people to know about them. Yes, it's not honest behavior, especially when one is entering into a marriage contract.

But if the person had no knowledge of their symptoms at that time and had no treatment, can you blame them for not touting their academic failure? I'm not sure I can.

I suggest that you focus now on creating the best foundation possible for your two children, whether or not you eventually decide to divorce. And, in my opinion, that means educating yourself about ADHD treatment strategies, finding a new psychiatrist, and perhaps an ADHD-savvy therapist who can help you.

I am not aware of the denial article, being very new to CHADD. But, I would love to read it. My husband is AD/HD; it's never been in doubt for me. But he is in major denial (he's in a midlife crisis, but denies that, too)......

---------Hi there,

If you are a CHADD member, one of the great benefits is that you can access the online archives of Attention magazine. (The articles on denial in Attention are excerpts from my book, so you can also read them there.)

First, a big congratulations to you for being so pro-active about your own ADHD-related challenges and also helping your children. This is really huge, as so many people find it easier (?) to just keep doing what they've always done and muddling through. You have taken an immense step to elevate your family.

If only your husband understood how lucky he is to have such an informed, pro-active wife and could join you at this new level of awareness and functioning!

Even though it's said that people with untreated/unrecognized ADHD often don't learn from consequences, it could be that your providing a safety net for your husband's ADHD deficits could be reinforcing his denial. If you remove that safety net (in ways that affect only him, not you and your children), he might start getting the message. But he might grow angry, too. Only you can know how safely you can do this.

With the help of the foremost expert on "denial," Dr. Xavier Amador, I offer tips on getting through denial in my book. One strategy is called LEAP. It's a relatively simple strategy but too involved to write out in a comment.

Another important strategy is getting your perceptions validated and receiving support. Therapy can help, but so can sharing support with others in the same boat.

I invite anyone whose partner has ADHD (diagnosed or likely) to join the free online discussion group SOLELY FOR THE PARTNERS OF ADULTS WITH ADHD, sponsored by CHADD of Northern California. I moderate it, along with several other longtime members.

http://health.dir.groups.yahoo.com/group/ADHD_Partner

Throughout the years, many people have joined the group, convinced that their partner's "denial" is impenetrable. But receiving support, sharing so many similar-sounding stories....it often has a way of dissolving denial. Hard to explain and not a 100 percent guarantee it will work that way for you. But it does for many people. And at least you will have a place where you can be heard and understood!

None of the ADHD therapists I found were able to diagnose or provide help for my marriage, after finding the best in the Washington D.C. Area. Although I participated in online support groups, reads books on living with a ADHD spouse and more.

When denial is combined with impulsive and hyper focused thinking, an ADHD person is quick to make of stories that even they believe. Impulsive thinking can come out without any thought or reflection on the real event. When denial is at play, they can quickly make up facts that's opposite from the truth. Because of their ability to hyperfocus on the story, they are very convincing, even if they go as far as to false reference others.

I found that they can even play on male biases and victimization to confuse female therapists. Some counselors have even refused to try and help because they said I can't tell who is telling the truth. Well denial and lying are two of the biggest symptoms,don't you methods to get to the truth aside from talking to the patient.

When I discuss the problems associated with ADHD, how would i know these things. And she denied them and tried turning the discussion into normal marital issues, which I don't deny. But we have a much bigger problem.

My research has not turned up any topics on the difficulty in diagnosis and treatment, which I have concluded is the biggest symptom.

None of the ADHD therapists I found were able to diagnose or provide help for my marriage, after finding the best in the Washington D.C. Area. Although I participated in online support groups, reads books on living with a ADHD spouse and more.

When denial is combined with impulsive and hyper focused thinking, an ADHD person is quick to make of stories that even they believe. Impulsive thinking can come out without any thought or reflection on the real event. When denial is at play, they can quickly make up facts that's opposite from the truth. Because of their ability to hyperfocus on the story, they are very convincing, even if they go as far as to false reference others.

I found that they can even play on male biases and victimization to confuse female therapists. Some counselors have even refused to try and help because they said I can't tell who is telling the truth. Well denial and lying are two of the biggest symptoms,don't you methods to get to the truth aside from talking to the patient.

When I discuss the problems associated with ADHD, how would i know these things. And she denied them and tried turning the discussion into normal marital issues, which I don't deny. But we have a much bigger problem.

My research has not turned up any topics on the difficulty in diagnosis and treatment, which I have concluded is the biggest symptom.

None of the ADHD therapists I found were able to diagnose or provide help for my marriage, after finding the best in the Washington D.C. Area. Although I participated in online support groups, reads books on living with a ADHD spouse and more.

When denial is combined with impulsive and hyper focused thinking, an ADHD person is quick to make of stories that even they believe. Impulsive thinking can come out without any thought or reflection on the real event. When denial is at play, they can quickly make up facts that's opposite from the truth. Because of their ability to hyperfocus on the story, they are very convincing, even if they go as far as to make false reference others.

I found that they can even play on male biases and victimization to confuse female therapists. Some counselors have even refused to try and help because they said I can't tell who is telling the truth. Well, isn't denial and lying two of the biggest symptoms? Don't they have methods to get to the truth aside from talking to the patient.

If I can discuss the problems associated with ADHD in detail, None of the ADHD therapists I found were able to diagnose or provide help for my marriage, after finding the best in the Washington D.C. Area. Although I participated in online support groups, reads books on living with a ADHD spouse and more.

When denial is combined with impulsive and hyper focused thinking, an ADHD person is quick to make of stories that even they believe. Impulsive thinking can come out without any thought or reflection on the real event. When denial is at play, they can quickly make up facts that's opposite from the truth. Because of their ability to hyperfocus on the story, they are very convincing, even if they go as far as to false reference others.

I found that they can even play on male biases and victimization to confuse female therapists. Some counselors have even refused to try and help because they said I can't tell who is telling the truth. Well denial and lying are two of the biggest symptoms,don't you methods to get to the truth aside from talking to the patient.

When I discuss the problems associated with ADHD in detail, how else would i know these things. And she denied them and tried turning the discussion into normal marital issues, which I don't deny. But ADHD is mental and a much bigger problem. I didn't seek therapy to attack and victimize, I was seeking help and solutions.

My research has not turned up any topics on the difficulty in diagnosis and treatment, which I have concluded is the biggest symptom.

Actually, denial and lying are not "two of the biggest symptoms" of ADHD. These behaviors are present sometimes, especially when symptoms are more severe.

As for denial itself, if you've read my book, you know that it can be tough for anyone to get through to the person who has "low insight." While it's great when a therapist has special skills in this area, but therapists are not miracle workers.

It's quite another thing, as you point out, for the therapist to be completely unfamiliar with the pattern. I guess she didn't read my book.

I hope you have been able to find a good life for yourself either in or after this marriage.

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About Me

San Francisco-based Adult ADHD expert Gina Pera is the author of a comprehensive guide for adults with ADHD and their partners: Is It You, Me, or Adult A.D.D.?

The book has received four national awards and has earned praise from professionals as well as adults with ADHD and their loved ones.

Gina Pera's previous journalistic work for USA WEEKEND magazine won the Unity Award in Media, which recognizes accurate exposure of issues affecting minorities and people with disabilities.

For the past decade, she has written about Adult ADHD while also advocating for better awareness and treatment standards. A popular international speaker, she leads ADHD discussion groups in Silicon Valley and an 800-member international online group for partners of adults with ADHD.

Click the cover below to learn more about Gina's guide for adults with ADHD and their partners